Ruth at Off-Label wrote a post titled A stigma wrapped in a history inside another stigma - that will probably never make it onto a t-shirt, about the stigma of the borderline personality disorder label within the c/s/x movement, and since my worrying about being an attention whore helped trigger it, I thought I’d talk about it. On and on and on about it. My post might not make much sense if you don’t read hers first, so you should read hers first. Some of this I first posted as a comment on her blog, but when I realized how long it was getting, I decided I’d take it over here:

Oh, don’t worry. It’s already made it onto a T-shirt. If I believed I had BPD, I would be perfectly willing to wear that shirt to any place that I would be willing to wear my “BIPOLAR PRINCESS” shirt.

I don’t think I have BPD, but I am well aware that I have some BPD traits, namely that I have mood swings, I used to cut myself, I am sometimes impulsive, and occasionally psychotic and dissociative. Although I think these are better explained by my diagnoses of bipolar disorder and PTSD, I’m open to the idea that maybe I could have BPD, or am possibly a recovered borderline still exhibiting some traits, or that DBT skills might help me regardless of diagnosis. I’ve got two volumes of Linehan and a copy of Get Me Out of Here by Rachel Reiland sitting in a pile of books on my floor, that’s how seriously I take these ideas.

I often wonder if BPD is a useful diagnosis at all… but I’ve met people both in real life and online who were diagnosed with BPD, who agreed with this diagnosis, and who are wonderful people. Because they feel that BPD is a useful construct for explaining some of their feelings and behaviours, and because some of them have received treatment for BPD that they feel has been effective, I don’t feel qualified in saying it must be purely complex PTSD, or it must be purely a different form of bipolar disorder, or it must be ONLY a label docs slap on women they don’t like. Since I don’t identify myself as having BPD, who am I to invalidate the experiences of people who do identify as such?

I couldn’t say whether the stigma of being an attention whore is greater than the stigma of being bipolar in the general population, but there’s definitely a stigma in the c/s/x community against borderline personality disorder. I don’t think, however, that this is usually because those of us in the c/s/x community actually look down upon people who have been diagnosed with BPD or who we perceive to be attention whores (note the “or” there: I’m not saying that these people are one and the same). In some cases, I’d say this is true, but honestly, I think most of us, including myself, are terrified of ourselves being misdiagnosed, or even correctly diagnosed, with BPD because we know that most mental health “professionals” will see it as a license to treat us like crap.

Last year I had the particular misfortune of being seen by doctors who didn’t seem to think it was possible to suffer from personality disorders and Axis I disorders at the same time. I’ve got no problem with someone dx’ing me borderline as long as they also are willing to treat my other issues, because there are some things that are big problems for me, mainly bipolar disorder and PTSD. The first half of 2006 was so traumatic for me that so far in this blog, I’ve just skirted around every mention of it. Well, it’s partly how traumatic it was, and partly because I know I’ll have to write some long, detailed posts about it, and I’ll have to set aside time for that.

Really, I don’t think most of us who are mentally interesting are prejudiced against people with BPD, we just desperately want to avoid the diagnosis ourselves, and with good reason, since the diagnosis virtually guarantees we’ll be insulted and mistreated by some of the “professionals” who are supposed to help us. This has the unfortunate side effect of making people with BPD feel like pariahs, since we so badly want to avoid either having BPD or being told that we do. I guess we should stop crowing about how glad we are that we haven’t been diagnosed with BPD if we don’t want to make other people feel like crap. Although I don’t really mean “we” there — I’m young, female, and a former self-injurer; of course there were some speculations that I have BPD.

And okay, if I ever decide that I agree with that suggestion and I am borderline, I will wear one of those T-shirts. No, I’m not kidding.

I might be less tolerant than I should of people whom I believe to be willfully manipulative, but I have thought that about very few people I know, and none of them carried a borderline diagnosis. I guess there are some borderlines who do fit the stereotype of being purposely manipulative, but I think most are just coping in the best ways they know how and other people misinterpret their actions. People who do have contempt for anybody with a BPD diagnosis — well, they shouldn’t. It’s disgusting to look down upon people with a different psychiatric label from yours, and it doesn’t help anybody.

Honestly, the part of my shirt I was so worried about? “PRINCESS.” Because if you’re going to go to the trouble of making a shirt that says you’re mentally ill, is it right to be so damn frivolous about it? It would be nice to make a shirt with a slogan that is serious and stigma-busting and actually wear it in public and actually teach people something. But I haven’t thought of one yet, and “BIPOLAR PRINCESS” amused me. (I couldn’t afford to buy enough packages of letters for “MANIC DEPRESSION HAS ITS UPS AND DOWNS.” That has six s’s and there were only two to a package.) The word “PRINCESS” just by itself could seem snobby and spoiled, which I’m not. Don’t get me wrong — I still don’t know if I’d ever wear a shirt that says “BIPOLAR” in public, but my “attention whore” comment referred more to the “PRINCESS” part. I don’t think it’s attention-whore-y when people make LJ icons that say “BIPOLAR PRINCESS,” so I don’t know if I worried about this because it was something I did offline, or just because it was me.

I also have very different standards for myself than I do for other people. I am very shy and usually try to avoid being the centre of attention. In the past, I have been accused of attention-seeking behaviour when I was doing nothing of the sort, and it really upset me. I also hate asking for help from anyone, even though I know that my frequent refusal to do so is just another weakness.

The really odd thing is that as I am sitting here typing this, I am wearing a T-shirt that says “WHAT WOULD FREUD DO?” on it. (It was a gift from a friend. I swear I don’t have a whole stack of psych-related T-shirts, just these two. No, wait, three. I’ve got one from a university psych department pub crawl.) I can guarantee you that most things Sigmund Freud would do, I would not do… but I wore this T-shirt in public today with absolutely no qualms about it.